If you are concerned about health insurance and medical services in Colombia, I share my recent experience with emergency surgery in Medellín.
In a number of Facebook groups, people from North America seem to be very concerned about health insurance and medical services in Colombia.
I just spent five days in Clínica León XIII receiving emergency surgery under Colombia’s equivalent of universal health care (EPS). I hope that my experiences might put a few fears to rest.
My background – I am British and 67 years old. And I am a firm supporter of the National Health Service. I had a heart attack in 2007, otherwise fairly healthy. I am married to a Colombian and linked to her EPS insurance with Commeva.
Clínica León XIII, Bloque 3, where surgeries are performed, photo courtesy of IPS Universitaria
My Clínica León Experience – Day 1: Wednesday
I arrived at Clínica León XIII at about 10am on Wednesday with a referral from a doctor in Synergie Salud, Jumbo, Las Vegas, plus an ultrasound scan I had had done.
The referral said I had “Colecistatis / Colelitisis” (Acute or chronic inflammation of the gallbladder, which is usually caused by the presence of stones). And that I had a temperature of 38°C (normal temperature is between 35.7°C and 37.3°C); severe pain; various other bits of squiggle finished by the word “prioritorio” (get a move on).
The ultrasound showed something like a Manta Ray swimming around my liver.
By 11 am, I had been examined by two different doctors to assess my level of urgency. Neither of them wanted to trust my rather splodgy ultrasound, containing as it did the useful advice: “this patient is ill”. And they wanted to have another ultrasound done – this never happened.
I was assessed as moderate since I was not vomiting, the pain appeared to be bearable and I was a fetching shade of Jonquil rather than the bright yellow that might have convinced them that I was a bit poorly. Priority: Triaje 3.
Clínica León XIII, Bloque 1, photo by SajoR
Moved to a Holding Room on Day 1
I was moved to a holding room containing eight reclining chairs. And I was attached to a drip supplying antibiotics and pain relief chemicals. By about 5 pm I was moved to a room in Bloque 1 (Block 1), anticipating that I would receive surgery that night, but no.
The room: two beds each with a metal locker, and a wash hand basin in the corner. The room is joined to the next one along by space containing a shower and bathroom. There was no shower head, and no seat for the toilet, but, major plus point: hot water for the stream of water in the shower unit!
Supplied in the room are a bed with two sheets and a rubberized pillow without a pillow case. No toilet paper, no soap, no towels.
In the next bed was an old gentleman attended by his daughter whom I can only affectionately describe as a “Mamacita”: a fairly typical Colombian matriarch who wanted to take over my life and treat me like a new-born.
Within seconds I had my bed made, a cover improvised for the pillow, my one or two possessions stored in my cupboard. I also received strict instructions to share the communal toilet paper, my nose was wiped and my bottom patted. I had not eaten all day and had no appetite. So, I had to endure at least half an hour of Mamacita trying to persuade me to have something to eat.
A nurse arrived with a machine with fairly irritating alarm sound, which connected me by a tube to a drip with a controlled supply of antibiotics and pain relief. I was finally informed that I would not go to surgery that day and Mamacita achieved one of her life goals by feeding me with something basically chicken that she brought in from outside in a box, plus a very welcome bottle of Quatro.
In the finish it was easier to get swept away in the cyclone of care, assistance and amiability that Paisas in general are famous for.
End of day one.
My Clínica León Experience – Day 2: Thursday
Various people showed up to talk to me loudly and slowly as part of a very useful patient care policy (no sarcasm intended here).
A doctor declared that he was going to operate on me, that I must eat nothing in anticipation of this welcome event. But he could not give me a time for the operation which would have to be scheduled by the mystical powers of León XIII. By 4pm, not hungry but still unfed and no sign of a trip to the operating theatre, I was treated to my first sample of hospital food á la León XIII.
“What was the food like?” is possibly the most frequently asked question regarding hospital treatment. I don’t suppose you want blow-by-blow details of the meals but suffice it to say that the food was basic but adequate; well prepared and very welcome.
The dinner lady appears to be proud of her work and almost seemed to take it a as a personal slight if she found a stray grain of uneaten rice on the plates when she collected the dishes.
My Clínica León Experience – Day 3: Friday
Still hovering in the air was the possibility that I would go to surgery today. I don’t remember the sequence of events that alerted me to the possibility that in fact Monday was going to be the chosen day for this much needed relief. But the poor little nurse who delivered the information probably wished that someone else had drawn the short straw.
Mamacita and I had a quick discussion (she is bilingual, which came in handy). And we went together to the huge desk behind which the tiny jefe nurse was hidden. I explained to her that I had not officially eaten for several days. And that I was attached to the world by a very uncomfortable tube filling me with chemicals that I needed before the operation, an operation that may only take place in four days’ time.
Why can’t I go home for the weekend and come back on their drip just before an appointed time and date for surgery? I felt as if I had entered a twilight zone of prioritization, which was not going to assign a time for my surgery until I was bright yellow, projectile vomiting and writhing in agony.
The nurse made some calls on my behalf and I was soon visited by a second doctor who claimed to be my surgeon. He told me that the magic event is now definitely for 1:30 pm on Saturday with the usual advice to not eat anything. An anesthetist showed up to examine my prostheses (false teeth) and enquire if I am allergic to any medicine, and that was it: Game On!
Emergency Surgery – Day 4
My Clínica León Experience – Day 4: Saturday – Emergency Surgery
Hang out the flags and bunting! Finally, the day of my emergency surgery had arrived.
Various rituals took place relating to plugging and unplugging my drip, the inevitable blood pressure tests, and the fitting of the tailor-made, back-to-front gown.
Speedy Gonzales whizzed me on a hospital stretcher to the surgery unit, and as I was transferred from general use hospital stretcher to the operating room hospital stretcher it was like passing into a different world.
The general hospital, while being clean, shows inevitable signs of wear and tear. From what I could see from where I lay in the operating room complex, everything was bright, sparkly, pristine efficiency. This was except for the bloody blood pressure units and their incessantly beeping bloody alarms.
Relaxed, calm and in control, the anesthetist and today’s lucky surgeon explained to me what was about to happen, and then ‘bye-bye cruel world’ with a couple of whiffs of gas-and-air.
My Clínica León Experience – Day 5: Sunday
I received a deputation from a medical team and some students, all standing far enough away from me so that they won’t catch anything. My wife ran around with bits of paper, paid a couple of bills, and that was it.
Ejected into a beautiful, sunny Medellín afternoon with my case history and a prescription for survival at home.
Clínica León XIII, Bloque 3, photo by SajoR
My Overall Emergency Surgery Impression
The bottom line, Clínica León XIII is OK, basic but adequate.
Room for improvement:
- I should have gone for emergency treatment a lot sooner than I did. After the initial searing pain in my abdomen I waited for the pain to go away, which it did to a degree. I was uncertain what course to pursue. And I was aware that making an appointment to see a general doctor was going to involve a delay anyway. My self-diagnosis suggested that my liver had finally given up the ghost. And since livers cannot be fixed, there seemed to be no rush to consult a quack anyway.
- I finally went to Urgencias in Clinica las Vegas. They were thoroughly uninterested in my plight since they do not deal with people like me on Commeva health insurance.
- The doctor in the Commeva facililty for Urgencias, Prosalco, diagnosed that I had Gall bladder problems. And I believe that he should have sent me straight to Clínica León XIII for emergency surgery. Instead he prescribed some really welcome pain relief and an ultra-sound scan. (NEXT).
- Because I arrived at Clínica León XIII several days after the onset of the pain and because I appeared to be stable, they chose not to operate as soon as they probably should have. When I went to surgery, they discovered that my bladder was in a very poor condition and it was close to infecting me with peritonitis.
- Assigning a date and time for the operation seemed to be unnecessarily vague.
- I was discharged with a prescription. And when I presented it in an official Commeva pharmacy, they were unable to supply three out of five of the items listed. Why does Clínica León XIII not have its own pharmacy, which can ensure the availability of medication needed to complete treatment for discharged patients? (I bought the pills I needed in a discount pharmacy store).
EMI is a medical service that works by attending you at home, or, in fact, anywhere you might start feeling ill. I had been thinking about signing up for this service for some time. And this recent experience has finally convinced me to do so. This cost is 84,000 pesos per month for myself and my wife.
More About Clínica León XIII
Clínica León XIII is administered by the University of Antioquia and opened in 1950. This hospital provides a variety of services including, surgery, outpatient, hospitalization, clinical laboratory, ICU for adults, neonatal ICU and emergencies.
Clínica León XIII reportedly handles over 1,000 surgeries per month and the hospital has about 3,500 employees.
Colombia has 24 of the best hospitals in Latin America and Medellin has nine of these best hospitals but Clínica León XIII isn’t on this list.
Colombia has 23 of the Best Hospitals in Latin America
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The Bottom Line: Emergency Surgery – My Experience at Clínica León XIII
Overall, I was quite satisfied with healthcare I received. I consider the healthcare was basic but completely adequate. But there was definitely some room for improvement.
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12 thoughts on “Emergency Surgery: Expat Experience in Clínica León XIII in Medellín”
I am not an expert in medical provision in Medellin but these remaks are courtesy of my Colombian wife.
SURA is the most widely accepted Insurer. They have a helpline where they can tell you which hospitals will accept you for treatment.
We have no idea if you need a referral from a doctor before you show up at the reception desk at ER, but that is the route I chose to go and it seemed to assist my admission to Leon XIII.
I have since signed up to EMI. This is a service associated with SURA which has a fleet of vehicles carrying medical personal who can attend you anywhere – at home, in the street, in a shopping centre – and they can arrange for admission to hospital if they are not able to treat you themselves. The cost is about COP85,000 per month and covers both of us. The huge benefit is that you call them, they deal with you very quickly, there is no waiting list/time for an appointment, they arrange for admission and take you to the hospital.
Yes, you can pay to see a specialist if you prefer. Expensive.
I hope this helps.
This is very helpful, thank you! I am type 1 diabetic so not eligible for prepago too. However with the basic EPS I do get all my medication for free each month. I have been wondering about the process for getting more treatment should me or my family need it in an emergency situation. I did take my son to an ER once as he had croup, but I just paid cash for that visit because I didn’t realise the hospital wouldn’t accept my insurance.
Two questions:
Are the various hospitals affiliated only with 1 insurer? You mentioned that with commeva, one of the facilities wouldn’t accept you. I have SURA EPS for example, would I go to a specific ER?
If you need some more serious medical attention, do you need to go to your “IPS” system (and deal with interminable waiting times for specialists) so that you’re in the correct system, or can you pay cash to see a specialist of your choice who can then recommend you book surgery etc at an affiliated hospital?
Yes, the surgery was by laparoscopy, and I have four small scars which are in the process of fading.
I had already been transferred from the surgery trolley onto the general use trolley when my memory of the event starts again after the operation. I was greeted by my wife who gave me an outline of what the surgeons had done and why; Speedy Mk II whizzed me back to the ward and I transferred myself from the trolley to my bed in a smooth rolling motion beloved of people rolling down grassy banks.
I dressed myself and enjoyed a bite of hospital food.
My next bit of memory is from Sunday when a nurse came to change my dressings. I have a fairly hairy chest, and most of the micropore, plus all of the stud things that were attached to monitor heartbeat, had been carefully stuck to hairy bits of me. The stud things had been attached by super-glue. The nurse managed to replace the dressings, but left me to deal with the studs myself which involved using scissors to trim my hair, and being very, very brave when I final ripped the things off my skin. You would have been proud of me.
So, the recovery room was my allotted room on the ward, in which Mamacita and her extended family were celebrating an early fathers’ day for her (generally unconscious) father. And quite frankly, they could have had a full Mariachi Band joining in the celebrations I was so glad to be free of pain.
On the drive home, everything seemed to be brighter, clearer and as if I was seeing Medellin for the first time. My sense of taste also seems to be more acute. I am eating less. My weight went up by 2 kilos in the hospital to 102 kilos; it has, until today, fallen to 91 kilos.
Can I finally mention that I have twice had surgery in England. On both occasions (1957 and 1967) the hospitals were still organised along the lines of open wards, with perhaps 30 beds per ward. The concept of a “recovery room” is new to me.
Would you tell us more about the surgery itself and your recovery room experience? I am guessing that they removed your gall bladder laparoscopically so you would have only had a couple of small incisions on your belly.
We have EPS/Sura. So far no complaints.
And keep in mind that because you are a Gringo you got the Royal treatment.
For me your experience is unacceptable
If people can’t buy prepaid medicine in Colombia, they should get their health care 3 hours away from here ( Miami)
Sergei,
I am not sure why you think I received Royal treatment in Leon XIII. Yes, I provided a bit of novelty value, mostly with the cleaners and with one or two of the nursing staff, because I am fairly ‘Mono’ and quite obviously a foreigner. Otherwise, I do not believe that I received more favourable treatment than anyone else.
Yes, there were some unacceptable delays in getting me to surgery, but I believe that these delays were of my own making by not going to Urgencias as soon as the pain in my abdomen started.
Finally, as a British citizen, it is unlikely that I will get on an airplane to Miami for surgery. Medellin is attractive to people from the USA as a destination for Medical Tourism since the doctors here have trained in the USA or Europe, and surgery here, if paid for privately, is much less expensive than in the USA.
Thanks for sharing your story and have a quick recovery. Regarding this statement:
EMI is a medical service that works by attending you at home, or, in fact, anywhere you might start feeling ill. I had been thinking about signing up for this service for some time. And this recent experience has finally convinced me to do so. This cost is 84,000 pesos per month for myself and my wife.
We wonder if anyone has used this service and can relate their experiences?
Thanks for sharing your experience and hope you are feeling well.
Thank you Mary, I am feeling the best I have done for ages.
Not all EPS is the same here and many employees have enhanced eps with services far and beyond básico servicios here. Can you be more specific as to the EPS you have. My friend had EPS through his wife who earns 4 million pesos a month. His EPS had resemblance to my basic run of the mill free servicio which I pay 102.000 pesos per month. I don’t beleive for one instant you have the same EPS as I have. The EPS terminology here is broad based and is far reaching and not at all equal.For all. You get what you pay for here in Colombia. The standard poor Mans EPS does not even come close to enhanced eps plans available to many who have corporate plans.
Ron,
My EPS (Entidad Prestadora de Salud) cover is with Coomeva. My wife has additional Prepago private cover. I did not qualify for this additional cover because of my age and medical history (heart attack).
The purpose of the story was to point out that even with a minimum insurance cover, I received medical treatment for the removal of my gall bladder without much fuss , and certainly without the hospital authorities asking for proof that I can afford ‘skin contact’ or any other such horrors that you might find on a hospital bill in the USA.
Yes, if I had been paying Prepago Insurance, then I might have had a private room in Las Americas and I might have been pampered accordingly. I have no complaints about Leon XIII. It appears to operate in a similar fashion to the NHS in the 1950s – basic but adequate.
John Heath